This rotation was particularly instructive because it involved a completely different method of patient care than any of my previous ones. The patient interview and mental state examination took the place of the history and physical examination. In addition, unlike a patient in an urgent care or emergency room where they can express exactly what their complaint is, the patients I assisted in treating in CPEP frequently lacked proper insight and good judgment and could not articulate the issue that caused them to present in the unit. I believe that as a result, my observational abilities have significantly increased, enabling me, for instance, to determine whether a mentally ill patient is internally concerned or if they are acting incoherently and bizarrely.
I enjoyed nearly every aspect of this rotation. First, it was nice to see a service that is largely run by PAs, many of whom had previously graduated from the York Program. Additionally, the staff seemed to enjoy having students around and were willing to give mini-lectures on disorders and medication classes and indications, while also bringing students along to see cases and conduct interviews. Moreover, they were all really mindful of our safety and what we were comfortable with. I recall an instance where one of the PAs wanted to take me to see a consult in the medical emergency room for a patient who was brought in for homicidal ideations and they would look for constant reassurance that I was comfortable seeing and speaking with patients that had aggressive and violent histories.
Of course, I want the staff and my preceptor to see that I am eager to learn on every rotation, I believe that was especially true for this rotation because it was one that I was particularly interested in. I would make a point to leave my comfort zone in an area I did not feel academically strong while offering to see as many patients as possible, ask questions as needed, and request to make patient notes whenever practical. The fact that the various doctors asked me to visit patients with them and trusted me to see their designated patients alone suggests that this translated well.